NT scan and triplescreen

hopinagain · 12-04-2008, 07:00 AM

anyone go through these tests? My scan went very well, my doc seemed very optimistic. he said that the nuchal fold was normal (1.7) and that since the babies nasal bone was developed that was also a very positive sign that downs was not an issue. but, we got the triple screen results back--for my age the general risk is 1/59 chances that a person my age will have a downs baby--my risk came back at 1/54. i was hoping for higher numbers. In my previous pg, my risk was a little lower but was almost the same as for my age group. i ended up getting an amnio and it was normal. so....now, i just don't know what to do. my DH thinks these numbers are hocus pocus, and that we should just rely on what our doc saw on the scans(and not get the CVS or amnio)--and try to be positive.

Any thoughts or experiences to help us figure all this out?

britt93 · 12-04-2008, 09:43 AM

At how many weeks were you when they did the NT scan?? Im 11 weeks and my doctor hasn"t even mentioned doing it... Im 37... hmm maybe she will at my 12 wk appointment next week....

Tia38 · 12-04-2008, 10:19 AM

are you sure you had a triple screen? many docs don't do them for 35+ because of known false positives (although it's a screen, not a diagnostic, so perhaps false positive is not the right term)

for me they did b/w along with the nt scan, but it was not the traditional triple screen. in my case, at 39 and again at 41 my NT scan was normal and nasal bone present. when the b/w results were folded in my risk of downs and trisomy13+18 (they separated the three issues into 2 categories) were decreased relative to age alone. but still felt a bit high to me.

both times we opted to wait for the level 2 scan (usually around 18w) to decide whether to do an amnio or not. at 39, it was a clear no amnio (u/s was great). dd (now 22 months) was fine (no issues).

currently at 41 u/s was great, but my numbers (going to back to NT+b/w) were still a bit riskier than i had hoped... but we decided to skip amnio this time too. won't know until april how it turns out.

can you talk to a genetic counselor? they can give you more details on risks, numbers and interpretations, and info on level 2 u/s. also ask about the loss rates for the clinic/doc where you would do your procedure. they often quote the national #s; what you care about are the numbers where you will have it done if you decide to do so.

in the end it's a personal decision, no right or wrong. for me, the cvs was too risky. i was really debating the amnio but in the end decided against.

i'm a bit with your hubby... i don't think it's all hocus pocus, but the screening numbers are just that -- screening. they are odds, not guarantees. even for someone who is 1/1,000,000,000 there could still be a problem. it's a slim chance, but still there.

dig back or search a bit on this board.... it's a topic that comes up quite a bit.

best of luck,
-tia

Sherb · 12-04-2008, 10:30 AM

Quote:

Originally Posted by britt93

At how many weeks were you when they did the NT scan?? Im 11 weeks and my doctor hasn"t even mentioned doing it... Im 37... hmm maybe she will at my 12 wk appointment next week....

britt, the nt scan should be done between 11 weeks and 12 weeks and 6 days for optimal results. I would call you Dr. and ask if you are concerned about getting it done.

I had mine done at 12 weeks 4 days and my nuchal fold was .9mm. I was told that anything below 3mm is normal. My numbers came back very good for my age at the time (37) but even so, I don't think we would have done the amnio because of the risk of m/c. My sister is due in January and her numbers were on the riskier side but she opted to wait until the level II u/s and everything was fine.

It's a very personal decision but good luck with the rest of your pregnancy.

hopinagain · 12-04-2008, 10:50 AM

thanks for responding! yes, it was definitely a triple screen. i have read a lot about "false positives" but my doc's office did not discuss it. Tia I agree with you about the terminology. i don't even like that they call my results "abnormal". i think it is very misleading. plus, even with my "abnormal" result, i have a 98% chance of not having a downs baby. I promised myself after doing the amnio with my DD that i would not put myself through this stress again, but here i am!

my next scan is at 20 weeks...i wonder if i could get them to move it up to 18 weeks. although i really don't think i would terminate, so i dont know why i am stressing so much...what will be will be. I sort of regret getting the triple screen....maybe not knowing would have been better!

i was 11 weeks 5 days, when they did my scan.

wintergirl · 12-04-2008, 11:00 PM

My NT scan was done a day or 2 shy of 13 weeks. I didn't get the exact number but was told it was normal and that the nasal bone was present.

I assumed I'd do amnio when I got pregnant due to my age (then 38, now 39) and I was told that women over 35 rarely "pass" the blood screening but I did pass. When I called the genetics dept at Kaiser to ask what the exact #'s were, they said Downs was less than 1 in 2,201 and the other trisomies were less than 1 in 4,601, so I opted not to do amnio.

I've heard that you can ask YOUR perinatologist exactly what his/her rates of m/c with amnio are. Don't just go by the national average.

Tia38 · 12-05-2008, 07:32 AM

Quote:

Originally Posted by hopinagain

t
my next scan is at 20 weeks...i wonder if i could get them to move it up to 18 weeks. although i really don't think i would terminate, so i dont know why i am stressing so much...what will be will be. I sort of regret getting the triple screen....maybe not knowing would have been better!

yes, sometimes all the technology and insight is more stressful than helpful.

if it were me, i would try to get them to move the screening up. with #1 i scheduled as early as possible. with this pg i had it scheduled (at doc's suggestion) at 18w, but then had to move it back to 19w+ -- and didn't think it would matter. doc encouraged me to move it back to 18w (which freaked me out a bit). but i was happy to have more info sooner rather than later.

if termination is a possibility (even if not likely) then having your u/s sooner would help give you better timing on a potential amnio should you decide to have one. i would raise the question to your doc and/or genetic counselor.

as i think i said, based on my 18w u/s we decided no amnio.

good luck with whatever you decide,
-tia

ivi · 02-03-2009, 08:43 PM

Hopinagain, my story is very similar to yours. In my case, I was 40 when i got prggnant with ivf. I had the NTS at 13.2 weeks and the fold was about 1.2, there was a nasal bone and this, combined with the blood gave me a chance of 1/695 for Downs, which is way better than that of a 35 y/o! But then, the triple scan gave me a 1/52 chance for Downs! I was torn up when deciding if I wanted to have the amnio, and after long discussions with DH we decided not to because we would not change anything even if positive. So we decided to wait, had the level II us at 18 wks, which showed no markers and the rest of the pregnancy went uneventful. But to tell you the truth, I wondered every day. My son was born last Friday, 30 JAN and does not have Downs or any other syndrome, thank God. As I now understand it, women my age should have the NTS as it is the standard for early screening, and should NOT have the triple screen, only test for AFP to screen for possible tubal defects. Given the older age, the triple screen will almost certainly come back with a high risk, and will give a lot of false positives. I hope you are doing well and good luck.

**BC-GoMom** · 02-08-2009, 02:37 PM

hopinagain,
Do you have an U/s coming up? Did you get it sooner? Don't forget to post an update!

hopinagain · 04-21-2009, 10:21 AM

hi everyone. sorry i never responded! i did have the scan and they did not detect any abnormal markers for downs. so that was comforting...though i confess i have had many moments where i feel panicky just not knowing. I have about 6 weeks left...so i am praying for a healthy baby girl! i will let you know how things go over the next few weeks. thanks for all your insights.

12-04-2008, 07:00 AM	#1 (permalink)
hopinagain 200-299 post 4 of hearts Join Date: Dec 2007 Location: usa Posts: 297	NT scan and triplescreen anyone go through these tests? My scan went very well, my doc seemed very optimistic. he said that the nuchal fold was normal (1.7) and that since the babies nasal bone was developed that was also a very positive sign that downs was not an issue. but, we got the triple screen results back--for my age the general risk is 1/59 chances that a person my age will have a downs baby--my risk came back at 1/54. i was hoping for higher numbers. In my previous pg, my risk was a little lower but was almost the same as for my age group. i ended up getting an amnio and it was normal. so....now, i just don't know what to do. my DH thinks these numbers are hocus pocus, and that we should just rely on what our doc saw on the scans(and not get the CVS or amnio)--and try to be positive. Any thoughts or experiences to help us figure all this out?

12-04-2008, 11:00 PM	#6 (permalink)
wintergirl 500-599 post 7 of hearts Join Date: Feb 2008 Location: San Jose, CA Posts: 505	My NT scan was done a day or 2 shy of 13 weeks. I didn't get the exact number but was told it was normal and that the nasal bone was present. I assumed I'd do amnio when I got pregnant due to my age (then 38, now 39) and I was told that women over 35 rarely "pass" the blood screening but I did pass. When I called the genetics dept at Kaiser to ask what the exact #'s were, they said Downs was less than 1 in 2,201 and the other trisomies were less than 1 in 4,601, so I opted not to do amnio. I've heard that you can ask YOUR perinatologist exactly what his/her rates of m/c with amnio are. Don't just go by the national average. __________________ Cari: 39, Tod 49; Sammy born 1/16/09

02-08-2009, 02:37 PM	#9 (permalink)
BC-GoMom BC:Preg+35/Gaming/Webkinz Join Date: Jan 2002 Location: Down South Posts: 4,917	hopinagain, Do you have an U/s coming up? Did you get it sooner? Don't forget to post an update! __________________ Mom of 6: DS - 10 yrs (IVF) DD - 8.5 yrs (IVF) DD - 7 yrs (Natural Surprise) DD/DS twins b/d 12/9/97 @22.5wks IC/PROM/GBS DS- 18.8 years -died Easter Sunday 2005 multiple disabilities since birth Mommy loves you all!

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12-04-2008, 09:43 AM	#2 (permalink)
britt93 100-199 post 3 of hearts Join Date: Jun 2008 Location: Mississippi (for now) Posts: 166	At how many weeks were you when they did the NT scan?? Im 11 weeks and my doctor hasn"t even mentioned doing it... Im 37... hmm maybe she will at my 12 wk appointment next week....

12-04-2008, 10:19 AM	#3 (permalink)
Tia38 1000-4999 post queen of hearts Join Date: Aug 2005 Location: USA Posts: 3,466	are you sure you had a triple screen? many docs don't do them for 35+ because of known false positives (although it's a screen, not a diagnostic, so perhaps false positive is not the right term) for me they did b/w along with the nt scan, but it was not the traditional triple screen. in my case, at 39 and again at 41 my NT scan was normal and nasal bone present. when the b/w results were folded in my risk of downs and trisomy13+18 (they separated the three issues into 2 categories) were decreased relative to age alone. but still felt a bit high to me. both times we opted to wait for the level 2 scan (usually around 18w) to decide whether to do an amnio or not. at 39, it was a clear no amnio (u/s was great). dd (now 22 months) was fine (no issues). currently at 41 u/s was great, but my numbers (going to back to NT+b/w) were still a bit riskier than i had hoped... but we decided to skip amnio this time too. won't know until april how it turns out. can you talk to a genetic counselor? they can give you more details on risks, numbers and interpretations, and info on level 2 u/s. also ask about the loss rates for the clinic/doc where you would do your procedure. they often quote the national #s; what you care about are the numbers where you will have it done if you decide to do so. in the end it's a personal decision, no right or wrong. for me, the cvs was too risky. i was really debating the amnio but in the end decided against. i'm a bit with your hubby... i don't think it's all hocus pocus, but the screening numbers are just that -- screening. they are odds, not guarantees. even for someone who is 1/1,000,000,000 there could still be a problem. it's a slim chance, but still there. dig back or search a bit on this board.... it's a topic that comes up quite a bit. best of luck, -tia

12-04-2008, 10:50 AM	#5 (permalink)
hopinagain 200-299 post 4 of hearts Join Date: Dec 2007 Location: usa Posts: 297	thanks for responding! yes, it was definitely a triple screen. i have read a lot about "false positives" but my doc's office did not discuss it. Tia I agree with you about the terminology. i don't even like that they call my results "abnormal". i think it is very misleading. plus, even with my "abnormal" result, i have a 98% chance of not having a downs baby. I promised myself after doing the amnio with my DD that i would not put myself through this stress again, but here i am! my next scan is at 20 weeks...i wonder if i could get them to move it up to 18 weeks. although i really don't think i would terminate, so i dont know why i am stressing so much...what will be will be. I sort of regret getting the triple screen....maybe not knowing would have been better! i was 11 weeks 5 days, when they did my scan.

02-03-2009, 08:43 PM	#8 (permalink)
ivi 100-199 post 3 of hearts Join Date: Nov 2007 Location: hawaii Posts: 129	Hopinagain, my story is very similar to yours. In my case, I was 40 when i got prggnant with ivf. I had the NTS at 13.2 weeks and the fold was about 1.2, there was a nasal bone and this, combined with the blood gave me a chance of 1/695 for Downs, which is way better than that of a 35 y/o! But then, the triple scan gave me a 1/52 chance for Downs! I was torn up when deciding if I wanted to have the amnio, and after long discussions with DH we decided not to because we would not change anything even if positive. So we decided to wait, had the level II us at 18 wks, which showed no markers and the rest of the pregnancy went uneventful. But to tell you the truth, I wondered every day. My son was born last Friday, 30 JAN and does not have Downs or any other syndrome, thank God. As I now understand it, women my age should have the NTS as it is the standard for early screening, and should NOT have the triple screen, only test for AFP to screen for possible tubal defects. Given the older age, the triple screen will almost certainly come back with a high risk, and will give a lot of false positives. I hope you are doing well and good luck.

04-21-2009, 10:21 AM	#10 (permalink)
hopinagain 200-299 post 4 of hearts Join Date: Dec 2007 Location: usa Posts: 297	hi everyone. sorry i never responded! i did have the scan and they did not detect any abnormal markers for downs. so that was comforting...though i confess i have had many moments where i feel panicky just not knowing. I have about 6 weeks left...so i am praying for a healthy baby girl! i will let you know how things go over the next few weeks. thanks for all your insights.